超声、增强CT诊断甲状腺癌颈部淋巴结转移比较的Meta分析

Comparison of ultrosound and contrast-enhanced CT in the diagnosis of cervical lymph nodes metastasis in patients with thyriod carcinoma： A meta-analysis

目的通过Meta分析对超声和增强CT（CECT）诊断甲状腺癌颈部淋巴结转移的临床价值进行评价。方法在美国生物医学数据库、荷兰医学文摘、Cochrance协作网和中国生物医学文献数据库中检索1995年1月-2012年12月以病理结果为金标准的关于超声、CECT诊断甲状腺癌颈部淋巴结转移的中英文文献，对纳入文献进行质量评价。采用Meta—Disc 1．4软件计算出汇总敏感度和特异度及95％可信区间，并绘制ROC曲线，得出Q^＊值，进行X检验。结果共17篇（1682例）文献被纳入。超声、CECT的合并敏感度和合并特异度分别为0．62、0．61和0．92、0．86。二者的ROC曲线下面积分别为0．84、0．82，二者Q^＊值（0．7718和0．7561）差异无统计学意义（P=0．78）。结论诊断甲状腺癌颈部淋巴结转移，超声与CECT诊断价值相当，但超声的特异度高于CECT。

Objective To evaluate the clinical value of ultrasound （US） and contrast-enhanced CT （CECT） in the diagnosis of cervical lymph nodes metastasis in patients with thyroid carcinoma by a recta- analysis. Methods Literature search was performed in Medline, Embase, Cochrane, CBM datebases to identify relevant English and Chinese literatures with pathological result as the gold standard from January 1995 to December 2012. The quality of each selected study was evaluated by QUADAS. The Meta-disc 1.4 software was used to calculate the pooled sensitivity, specificity and the corresponding 95% CI. Summary receiver operating characteristic curves （ROC）, area under curve （AUC） and the Q^＊ index were calculated and used to evaluate the diagnostic efficiency of the two methods by Z test. Results Totally seventeen literatures （ 1 682 patients） were included, the pooled sensitivity and specificity for and CECT scanning were 0.62, 0.61 and 0.92, 0.86. The AUC of the two were 0.84, 0.82 respectively. There was no statistically significant difference between US and CT （P =0.78） in the Q^＊ index（0.7718, 0.7561 ）. Conclusions US and CECT have similar value in the diagnosis of cervical lymph nodes metastasis in patients with thyroid carcinoma, but there is higher specificity in US than that in CECT.